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Mohsen S, El-Gilany AH, Essam N. Effect of Ramadan fasting on changes in smoking and vaping behaviors and withdrawal symptoms severity: a cross-sectional study. J Addict Dis 2024:1-11. [PMID: 38790079 DOI: 10.1080/10550887.2024.2354565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
BACKGROUND Ramadan fasting, an obligatory duty for adult Muslims, entails refraining from eating, drinking, smoking, and vaping from dawn until sunset. Throughout Ramadan, people accept major changes to daily routines. Consequently, Ramadan is associated with abstinence symptoms and changes in smoking or vaping behavior. AIM The study aims to assess the presence of withdrawal symptoms and its severity, as well as smoking or vaping behavior change and its determinants during Ramadan fasting. METHODS A cross-sectional study was conducted during Ramadan in 2023. Data were collected online using a Google form, including questionnaires assessing socio-demographic data, nicotine dependence using Fagerstrom Test for Nicotine Dependence, vaping and shisha smoking, presence and severity of physiological and psychological withdrawal symptoms and its coping strategies. Smoking and vaping behavioral change during Ramadan and its contributing factors were also evaluated. RESULTS A total of 251 participants (96% males), mean age ± standard deviation (33 ± 12.1) were surveyed. Withdrawal symptoms were reported among 70.5%, however, their severity was generally low both physiologically and psychologically. Education, nationality, smoking duration, nicotine dependence, and the amount of consumed E-liquid per day were the independent predictors of withdrawal symptoms presence. Attempts to quit smoking and vaping were reported by 54.6% of the participants; young age and higher educational levels were the factors associated with more quitting attempts. CONCLUSIONS The withdrawal symptoms severity linked to Ramadan fasting is minimal. Many smokers and vapers made attempts to quit during Ramadan. Ramadan presents a chance for smoking and vaping cessation with some behavioral support.
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Affiliation(s)
- Shorouk Mohsen
- Department of Public Health and Community Medicine, Faculty of Medicine, Mansoura University, Mansoura City, Egypt
| | - Abdel-Hady El-Gilany
- Department of Public Health and Community Medicine, Faculty of Medicine, Mansoura University, Mansoura City, Egypt
| | - Noha Essam
- Department of Public Health and Community Medicine, Faculty of Medicine, Mansoura University, Mansoura City, Egypt
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2
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Fatani BZ, Al‐Yahyawi H, Raggam A, Al‐Ahdal M, Alzyoud S, Hassan AN. Perceived stress and willingness to quit smoking among patients with depressive and anxiety disorders seeking treatment. Health Sci Rep 2022; 5:e503. [PMID: 35229052 PMCID: PMC8867423 DOI: 10.1002/hsr2.503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/04/2021] [Accepted: 12/12/2021] [Indexed: 11/16/2022] Open
Abstract
Rationale and objectives Little are known about nicotine dependence (ND), perceived stress, and willingness to quit smoking at different treatment stages in patient with affective disorders (AD). This study aimed to evaluate the association between ND and perceived stress among patients with AD presenting with psychiatric treatment at different clinical stages (first visit or follow‐up), and in different nicotine type users (cigarette and waterpipe smokers). We also aimed to evaluate the willingness to quit smoking and its association with barriers to quitting. Methods This cross‐sectional mixed‐method study collected quantitative and qualitative data from patients (n = 57) presenting for treatment with AD and ND at different sites in Saudi Arabia. Quantitative validated scales were used to assess the 70 of depression symptoms, anxiety symptoms, perceived stress, and ND. Qualitative questions assessed barriers to quit smoking. We used a linear regression modeling to estimate the association between ND and perceived stress as well as to estimate the association between barrier to quit and willingness to quit. Results ND had a statistically significant association with perceived stress (odds ratio [OR]: 2.09; 95% confidence interval [CI]: 1.20‐3.63). Participants in the follow‐up group had a higher ND score than those in the first‐visit group. One of the most commonly reported barriers to quitting was using nicotine as a stress management (33.3%), which predicted positive willingness to quit (OR: 2.23; 95% CI: 1.48‐3.37; P < .01). Boredom was reported as a barrier in the waterpipe group more than cigarette group. Conclusion ND has a significant association with perceived stress regardless of treatment status in patients with AD, indicating the need to evaluate smoking cessation during the early stages of treatment for patients with AD and ND. It will be critical for clinicians to offer patients with AD alternative coping mechanisms to manage stress and boredom.
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Affiliation(s)
- Bayan Zaid Fatani
- Department of Psychiatry King AbdulAziz Medical City Jeddah Saudi Arabia
| | - Huda Al‐Yahyawi
- Department of Medicine, Psychiatry Division King AbdulAziz University Jeddah Saudi Arabia
| | | | - Mutaz Al‐Ahdal
- Department of Medicine, Psychiatry Division King AbdulAziz University Jeddah Saudi Arabia
| | - Sukaina Alzyoud
- Department of Community and Mental Health Nursing The Hashemite University Zarqa Jordan
| | - Ahmed N. Hassan
- Department of Medicine, Psychiatry Division King AbdulAziz University Jeddah Saudi Arabia
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
- Departments of Pharmacology and Toxicology University of Toronto Toronto Canada
- Institute of Medical Sciences, University of Toronto Toronto Ontario Canada
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3
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ElShahawi HH, Amin GR, Khalil SA, Morsy MH, Farwiez MG, Nawara MM. Prevalence of tobacco smoking in a sample of general secondary school students in Cairo and its correlation to other psychiatric disorders. MIDDLE EAST CURRENT PSYCHIATRY, AIN SHAMS UNIVERSITY 2022; 29:87. [PMCID: PMC9558021 DOI: 10.1186/s43045-022-00252-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background Tobacco smoking is considered currently a global public health concern among youth especially school students. There is a scarcity of data about the impact of this global phenomenon in Middle Eastern countries. This study assesses the prevalence of tobacco smoking, including conventional cigarettes, E-cigarettes, and water pipe and its sociodemographic and psychiatric correlates among a sample of general secondary school students in Cairo, Egypt. Results A convenient sample of 391 Egyptian general secondary students from different areas of Greater Cairo were assessed using the Socioeconomic scale, Fagerstrom Test For Nicotine Dependence, The Lebanon Water pipe Dependence Scale, questionnaire for electronic cigarette use, Barratt impulsivity scale 11, and The MINI International Neuropsychiatric Interview for Children and Adolescents. 12.8% (n = 50) were smokers. There is a significant relation between family history of smoking and substance use and smoking and significant relation between smoking, impulsivity, and mood symptoms. Conclusions Prevalence of tobacco smoking in Egyptian adolescents was 12.8% with significant relation between smoking and impulsivity and mood symptoms.
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Affiliation(s)
- Heba Hamed ElShahawi
- grid.7269.a0000 0004 0621 1570Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ghada Refaat Amin
- grid.7269.a0000 0004 0621 1570Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sherien Ahmed Khalil
- grid.7269.a0000 0004 0621 1570Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mahmoud Hassan Morsy
- grid.7269.a0000 0004 0621 1570Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Gamal Farwiez
- grid.7269.a0000 0004 0621 1570Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt ,grid.7269.a0000 0004 0621 1570Okasha Institute of Psychiatry, Ain Shams University, 22, Dair Al-Malak, Abbassia, Cairo, 11657 Egypt
| | - Mayar Medhat Nawara
- grid.7269.a0000 0004 0621 1570Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Derbel K, Maatoug C, Mchita A, Mabrouk KH, Saad HB. Self-Reported Smoking Status 10-Months After a Single Session Intervention Including an Education Conference About Smoking Harms and Announcement of Spirometric Lung-Age. CLINICAL MEDICINE INSIGHTS-CIRCULATORY RESPIRATORY AND PULMONARY MEDICINE 2021; 15:11795484211047041. [PMID: 34690503 PMCID: PMC8532218 DOI: 10.1177/11795484211047041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022]
Abstract
Background Studies investigating the effects of announcing spirometric lung-age (SLA) on the smokers' self-reported smoking status reported conflicting results. Main objective To evaluate the effects of a single session intervention including an education conference about smoking harms and announcement of SLA on the participants' self-reported smoking status. Methodology An interventional study was conducted in a cable factory. The intervention included four steps: PowerPoint presentation about raising smoking hazards awareness; general questionnaire; measurement of the anthropometric and spirometric data, and announcement of SLA; and evaluation of the smokers' self-reported smoking status 10 months later (quitted smoking, decreased consumption; stable consumption, increased consumption). Results Thirty-six smokers completed the four steps. Ten months after the intervention, 11.1% of smokers quitted smoking, 52.7% decreased their consumption by 7 ± 4 cigarettes/day, 30.5% kept a stable consumption, and 5.5% increased their consumption by 9 ± 6 cigarettes/day. Conclusion Providing an education conference combined with announcing SLA motivated 64% of smokers to quit smoking or to reduce their cigarette consumption.
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Affiliation(s)
- Khansa Derbel
- Laboratory of Physiology and Functional Explorations, Farhat HACHED Hospital, Sousse, Tunisia
| | | | - Amira Mchita
- Occupational Medicine Group of Sousse, Sousse, Tunisia
| | | | - Helmi Ben Saad
- Laboratory of Physiology and Functional Explorations, Farhat HACHED Hospital, Sousse, Tunisia.,Occupational Medicine Group of Sousse, Sousse, Tunisia.,Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia.,Université de Sousse. Faculté de Médecine de Sousse. Laboratoire de Physiologie. Sousse, Tunisie
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5
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Hallit S, Barrada JR, Salameh P, Sacre H, Roncero M, Obeid S. The relation of orthorexia with lifestyle habits: Arabic versions of the Eating Habits Questionnaire and the Dusseldorf Orthorexia Scale. J Eat Disord 2021; 9:102. [PMID: 34391484 PMCID: PMC8364025 DOI: 10.1186/s40337-021-00455-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 08/04/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Some of the commonly used tools to assess orthorexia nervosa (OrNe) do not allow a meaningful interpretation of the scores or yield mixed results about the dimensions needed to represent orthorexia. Since no advancement in the theoretical knowledge can be made without a thorough examination of the measurement aspects, this study aimed to evaluate the correlation between orthorexia nervosa (OrNe) and lifestyle habits, notably alcohol drinking, cigarette and waterpipe smoking, and physical exercise, and to validate and assess the psychometric properties of the Arabic versions of the Eating Habits Questionnaire (EHQ) and Düsseldorf Orthorexia Scale (DOS). METHODS A total of 456 adult participants completed a self-administered questionnaire. Exploratory structural equation models were used to test the internal structure of the instruments. Shorter and more explicit versions were proposed for instruments. Pearson and partial correlations were computed between orthorexia scores and healthy behaviors scores. RESULTS Regarding the internal structure of both EHQ and DOS, evidence favored the bi-dimensional construct of orthorexia. Both tools presented two theoretically clearly interpretable factors (OrNe and Healthy Orthorexia-HeOr-). The two questionnaires presented a high convergent validity, as dimensions with the same interpretation were correlated around 0.80. While OrNe was positively correlated with the use of unhealthy substances (higher alcohol use disorder, cigarette, and waterpipe dependence), HeOr was negatively associated with these behaviors. CONCLUSION Our results emphasize the idea that further attention should be paid to the multidimensional structure of orthorexia, as OrNe and HeOr present an opposite pattern of associations with healthy behaviors. An OrNe etiopathogenesis common to eating disorders can explain these differences.
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Affiliation(s)
- Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,INSPECT-LB, Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon.
| | - Juan Ramón Barrada
- Facultad de Ciencias Sociales y Humanas, Universidad de Zaragoza, Teruel, Spain
| | - Pascale Salameh
- INSPECT-LB, Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon.,University of Nicosia Medical School, Nicosia, Cyprus
| | - Hala Sacre
- INSPECT-LB, Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon
| | - María Roncero
- Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Sahar Obeid
- INSPECT-LB, Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie, Beirut, Lebanon. .,Research and Psychology Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon. .,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
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6
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A Clinical Trial to Assess the Role of Repetitive Transcranial Magnetic Stimulation in Smoking Cessation in an Egyptian Sample. ADDICTIVE DISORDERS & THEIR TREATMENT 2021. [DOI: 10.1097/adt.0000000000000292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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7
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Sharma MK, Suman LN, Srivastava K, Suma N, Vishwakarma A. Psychometric properties of Fagerstrom Test of Nicotine Dependence: A systematic review. Ind Psychiatry J 2021; 30:207-216. [PMID: 35017802 PMCID: PMC8709504 DOI: 10.4103/ipj.ipj_51_21] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/24/2021] [Accepted: 06/01/2021] [Indexed: 11/25/2022] Open
Abstract
The Fagerstrom test for nicotine dependence (FTND) is a widely used test for assessing physical nicotine dependence. However, there is a need to assess the psychometric properties of FTND to assess its role in treatment outcome studies. The aim of the present investigation was to review the psychometric properties of the FTND. A broad systematic literature search was performed from Pubmed and PsycINFO from 2000 to 2019. The publication language was limited to English. Two review authors performed the study selection and extracted the data. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Rayyan software used to screen relevant studies. A total of 1471 articles retrieved from the search, of which 33 studies fulfilled the inclusion criteria. Eleven studies related to testing the reliability of the FTND were analyzed. Twenty-five studies evaluated the Cronbach alpha of the test. Analysis of the studies revealed the questionable psychometric qualities of the adapted versions of the test across different cultures and ethnicity. It also suggested that it may not tap the appropriate constructs that would predict smoking patterns in light smokers, e-cigarette smokers, and smokeless tobacco users. Thus, further research must focus on improving the psychometric properties of FTND to enhance the measurement of nicotine dependence.
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Affiliation(s)
- Manoj Kumar Sharma
- SHUT Clinic (Service for Healthy Use of Technology), Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - L N Suman
- Department of Clinical Psychology,National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Kalpana Srivastava
- Department of Psychiatry, Defence Research and Development Service, Armed Forces Medical College, Pune, Maharashtra, India
| | - N Suma
- Department of Clinical Psychology,National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Akash Vishwakarma
- Department of Clinical Psychology,National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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8
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Alageel AA, Alyahya RA, A Bahatheq Y, Alzunaydi NA, Alghamdi RA, Alrahili NM, McIntyre RS, Iacobucci M. Smartphone addiction and associated factors among postgraduate students in an Arabic sample: a cross-sectional study. BMC Psychiatry 2021; 21:302. [PMID: 34112121 PMCID: PMC8193897 DOI: 10.1186/s12888-021-03285-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 05/13/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Smartphone addiction, as with other behavioral addictions, is associated with social, physical, and mental health issues. In this article, we investigated the prevalence of smartphone addiction among postgraduate students and evaluated its correlation with social demographics, depression, attention-deficit/hyperactivity disorder (ADHD), and nicotine dependence. OBJECTIVES The objective of this study was to investigate the prevalence of smartphone addiction among Middle Eastern postgraduate students, determine the factors associated with smartphone addiction, and estimate the incidence rate of major depressive disorder (MDD), ADHD, insomnia, and nicotine addiction among postgraduate students with smartphone addiction. METHODS As part of a cross-sectional online survey, participants were given a self-questionnaire divided into six sections: Socio-demographics, Smartphone Addiction Scale (SAS), Patient Health Questionnaire (PHQ9) for Depression, Athens Insomnia Scale (AIS), the Fagerström Test for Cigarette Dependence Questionnaire (FTCd), and the adult ADHD Self-Report Scale (ASRS-v1.1). RESULTS Of the 506 patients, 51.0% of the participants demonstrated smartphone addiction. A significant association was also observed between extensive smartphone use and MDD (P = 0.001). Of the smokers in this study, 41.5% were addicted to smartphones (P = 0.039). Smartphone addicts had approximately two times the chance of having insomnia (OR = 2.113) (P = 0.013). In addition, they showcased more ADHD symptoms (OR = 2.712) (P < 0.001). CONCLUSIONS We found a positive association among insomnia, depression, adult ADHD, and smartphone addiction, which confirms the findings reported in the previous studies. Therefore, we encourage the scientific community to further study the impacts of smartphone addiction on the mental health of postgraduate students.
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Affiliation(s)
- Asem A Alageel
- Assistant Professor of Psychiatry, Department of Clinical Neurosciences, College of Medicine, Al-Imam Muhammad Ibn Saud Islamic University (IMSIU), P.O. Box 26181, Riyadh, 11486, Saudi Arabia.
| | - Rayyan A Alyahya
- Collage of Medicine, Al-Imam Muhammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
- Prince Sultan Military Medical City (PSMMC), Riyadh, Saudi Arabia
| | - Yasser A Bahatheq
- Collage of Medicine, Al-Imam Muhammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | | | - Raed A Alghamdi
- Collage of Medicine, Al-Imam Muhammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Nader M Alrahili
- Department of Clinical Neurosciences, College of Medicine, Al Imam Mohammad ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Michelle Iacobucci
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
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9
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Parenting Styles and Psychiatric Profile of Parents of Adult Substance Use Disorder Patients: Cross-sectional Study. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00554-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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10
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Dib JE, Haddad C, Sacre H, Akel M, Salameh P, Obeid S, Hallit S. Factors associated with problematic internet use among a large sample of Lebanese adolescents. BMC Pediatr 2021; 21:148. [PMID: 33781242 PMCID: PMC8006342 DOI: 10.1186/s12887-021-02624-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/23/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND International literature clearly describes factors associated with problematic internet use, including substance dependence, online gambling, social impairment, and functional difficulties. Therefore, it was imperative to assess the extent to which young adolescents in Lebanese schools are affected by problematic internet use (PIU) and the factors associated with it. This large-scale Lebanese survey aims to evaluate the relationship between PIU, depression, and substance use, including alcohol consumption and nicotine use (cigarettes and waterpipe) among adolescents in Lebanese schools. METHODS This cross-sectional study conducted between January and May 2019 assessed internet use through the Internet Addiction Test (IAT), with 'severe internet use' being the threshold for problematic internet use. It enrolled a total of 1810 adolescents aged 14 to 17 from 16 schools from all Lebanese Mohafazat. RESULTS The majority of the participants had an average internet use 74.8% (95% Confidence Interval (CI): 0.72-0.76), 20.7% (95% CI: 0.18-0.22) had a frequent internet use, and 4.5% (95% CI: 0.03-0.05) had a severe internet use. Higher alcohol dependence (ß = 0.456, p < 0.001), higher depression (ß = 0.079, p = 0.001), and having separated parents vs. living together (ß = 0.136, p < 0.001) were significantly associated with higher IAT scores. Higher waterpipe dependence (ß = -0.218, p < 0.001) was significantly associated with lower IAT scores. CONCLUSION This study, the first and largest of its kind in the Middle East, showed that some psychiatric disorders, such as depression and substance use (smoking and alcohol), are associated with more problematic internet use among Lebanese adolescents. These results could serve as the first step for policymakers towards implementing early awareness campaigns to look at this problem more in-depth and come up with efficient actions to avoid it.
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Affiliation(s)
- Joseph E Dib
- Division of Psychiatry and Clinical Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Chadia Haddad
- Research and Psychology Departments, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France
- Univ. Limoges, UMR 1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, 87000, Limoges, France
- CH Esquirol, Department of Psychiatry, 87025, Limoges, France
| | - Hala Sacre
- INSPECT-LB (National Institute of Public Health, Clinical Epidemiology and Toxicology), Beirut, Lebanon
| | - Marwan Akel
- INSPECT-LB (National Institute of Public Health, Clinical Epidemiology and Toxicology), Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB (National Institute of Public Health, Clinical Epidemiology and Toxicology), Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
| | - Sahar Obeid
- Research and Psychology Departments, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon.
- INSPECT-LB (National Institute of Public Health, Clinical Epidemiology and Toxicology), Beirut, Lebanon.
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Souheil Hallit
- INSPECT-LB (National Institute of Public Health, Clinical Epidemiology and Toxicology), Beirut, Lebanon.
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
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11
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Pattern of Tobacco Smoking Among Egyptian Patients With Bipolar Disorder. ADDICTIVE DISORDERS & THEIR TREATMENT 2021. [DOI: 10.1097/adt.0000000000000248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Salah RA, Malak MZ, Bani Salameh AK. Relationship between shift-work and life-style behaviors among emergency department nurses in Jordan. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 77:27-34. [PMID: 33319635 DOI: 10.1080/19338244.2020.1841721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Shift-work can alter the nurses' lifestyle behaviors, which negatively influence health. This study is purposed to assess the relationship between shift-work and selected lifestyle behaviors including, dietary habits, physical activity, and nicotine dependence among Jordanian nurses who work at the emergency department. A cross-sectional, descriptive correlational design was used. A total of 275 Jordanian nurses from the emergency department of Jordanian hospitals participated in the questionnaire. The results showed that 50.2% of the nurses suffered from poor dietary habits, 81.8% of them were physically inactive, and 65.1% had nicotine dependence. There was a positive correlation between shift-work, dietary habits, physical activity, and nicotine dependence. Therefore, the effects of shift-work should be considered when planning and developing interventional programs to enhance nurses' health and promote healthy behaviors among nurses workforce during shift-work.
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Affiliation(s)
- Rayyan A Salah
- Adult Health Nursing, Ministry of Health, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Malakeh Z Malak
- Community Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Ayman K Bani Salameh
- Pediatric Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
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13
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Haddad C, Darwich MJ, Obeid S, Sacre H, Zakhour M, Kazour F, Nabout R, Hallit S, Tahan FE. Factors associated with anxiety disorders among patients with substance use disorders in Lebanon: Results of a cross-sectional study. Perspect Psychiatr Care 2020; 56:745-752. [PMID: 31793708 DOI: 10.1111/ppc.12462] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 11/23/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Estimate the rate of anxiety disorders (AD) and associated factors among patients with substance use disorder (SUD) in Lebanon. METHODS A cross-sectional study, conducted between April and September 2017, enrolled 57 inpatients with SUD. RESULTS The rate of AD in patients with SUD was 61.4%. The university level of education compared to the primary level of education (ORa = 0.221) was significantly associated with lower anxiety among patients with SUD. Being sexually abused and having a family history of depression tended to significance. PRACTICAL IMPLICATIONS AD is widespread in Lebanon and high rates of anxiety in patients with SUD were found, warranting the implementation of strategic interventions and establishing national policies and legislation for mental health services to provide optimal care.
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Affiliation(s)
- Chadia Haddad
- Departments of Research, Psychiatry and Psychology, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | | | - Sahar Obeid
- Departments of Research, Psychiatry and Psychology, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Maha Zakhour
- Faculty of Sciences, Lebanese University, Fanar, Lebanon
| | - Francois Kazour
- Departments of Research, Psychiatry and Psychology, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Sciences, Lebanese University, Fanar, Lebanon.,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,INSERM U930, équipe 4 "Troubles affectifs", Université François-Rabelais de Tours, Tours, France.,Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Rita Nabout
- Faculty of Sciences, Lebanese University, Fanar, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.,Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Fouad E Tahan
- Departments of Research, Psychiatry and Psychology, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Faculty of Sciences, Lebanese University, Fanar, Lebanon
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14
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Association and Possible Correlations Between Tobacco Smoking and Symptoms of ADHD in an Egyptian Medical College Students’ Sample. ADDICTIVE DISORDERS & THEIR TREATMENT 2020. [DOI: 10.1097/adt.0000000000000217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Abou-ElWafa HS, Zoromba MA, El-Gilany AH. Cigarette smoking at workplace among resident physicians and nurses in Mansoura University Hospital. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 76:37-44. [PMID: 32469291 DOI: 10.1080/19338244.2020.1771249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Smoking at workplace (WP) is common among healthcare workers. A cross-sectional study was conducted upon resident physicians and nurses to determine the prevalence of WP smoking and its associated factors. A questionnaire was used to collect socio-demographic and occupational data, smoking history, nicotine dependence, and attitude toward smoking and its control in WP. More than one-fifths (22.7%) of residents and nurses were current WP smokers. Significant independent predictors are having shift work, high nicotine dependence, and having positive attitude toward smoking with AOR (95% CI): 29.4 (4.9-177.1), 18.2 (3.3-101.1), and 0.16 (0.02-0.84), respectively. The prevalence of smoking among resident physicians and nurses in Mansoura University Hospital is relatively high. Enforcement of WP smoking-free policies is required together with encouragement of positive attitude toward smoking cessation.
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Affiliation(s)
- Hala Samir Abou-ElWafa
- Public Health & Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed Ali Zoromba
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Abdel-Hady El-Gilany
- Public Health & Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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16
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Abstract
Our objective was to assess factors associated with the physical (Short-Form 12-physical component summary [SF-12-PCS]) and mental (Short-Form 12-mental component summary [SF-12-MCS]) quality of life (QOL) in the Lebanese population. A cross-sectional study, conducted between July and September 2017, enrolled 57 patients with substance use disorder from the Psychiatric Hospital of the Cross. The SF-12 scale was used to assess the QOL among participants. A first stepwise linear regression, using the SF-12-PCS score as the dependent variable, showed that females compared with males (β = -4.86) and having a family history of substance use disorder (β = -4.70) were associated with lower physical QOL (lower SF-12-PCS scores). A second stepwise linear regression, using the SF-12-MCS score as the dependent variable, showed that having a generalized anxiety disorder (β = -10.52) and having suicidal ideation (β = -8.05) were associated with lower mental QOL (lower SF-12-MCS scores). Strategic interventions are needed to manage the health-related QOL in those with substance abuse.
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17
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The Tangled Relation Between Tobacco and Substance Abuse in Egyptian Male Patients. ADDICTIVE DISORDERS & THEIR TREATMENT 2018. [DOI: 10.1097/adt.0000000000000132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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18
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El Mhamdi S, Lemieux A, Ben Salah A, Bouanene I, Ben Salem K, al'Absi M. Exposure to community and collective violence during childhood and tobacco use patterns among young adults in Tunisia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:935-945. [PMID: 30047613 DOI: 10.1111/hsc.12623] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 05/30/2018] [Accepted: 06/21/2018] [Indexed: 06/08/2023]
Abstract
Accumulating evidence demonstrates that experiencing intrafamilial adversities (abuse, neglect and household dysfunction) during childhood is linked to addictive behaviours. However, the impact of social adversities (peer, community and collective violence) as well as gender, on tobacco initiation and dependence has received much less attention. The aim of this study was to examine the relationships between social childhood adversities and tobacco use patterns by gender among young adults in Tunisia. We performed a cross-sectional study from May to December, 2014 on 1,200 respondents using the validated Arabic version of the World Health Organization Adverse Childhood Experiences-International questionnaire (WHO ACE-IQ). Data on smoking characteristics among current smokers were also collected. Data analysis was performed using logistic and linear regression models. The rate of current tobacco use was significantly higher for males (43.9%) than for females (9.3%). Female and male respondents differed significantly on almost every examined adversity. Males were more likely to have experienced all types of social violence than females. The odds of tobacco use were significantly higher regardless the mental health status and the occurrence of intrafamilial early life adversity for both genders. Smokers exposed to social violence during childhood had a strong association between nicotine dependence and the overall burden of adversity. That is, 74 and 58% of nicotine dependence was explained by the number of childhood social adversities in females and males respectively. The findings underscore the role of community and collective violence in addictive behaviours among young adults. Multisectorial and population-based strategies are needed to minimise the occurrence of social early life adversity and related tobacco patterns.
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Affiliation(s)
- Sana El Mhamdi
- Department of Preventive and Community Medicine, University Hospital Tahar Sfar, Mahdia, Tunisia
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia
- Research laboratory "Epidemiology Applied to Maternal and Child Health" 12SP17, Tunisia
| | - Andrine Lemieux
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN
| | - Arwa Ben Salah
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia
- Research laboratory "Epidemiology Applied to Maternal and Child Health" 12SP17, Tunisia
| | - Ines Bouanene
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia
- Research laboratory "Epidemiology Applied to Maternal and Child Health" 12SP17, Tunisia
| | - Kamel Ben Salem
- Department of Community Medicine, Faculty of Medicine, University of Monastir, Tunisia
- Research laboratory "Epidemiology Applied to Maternal and Child Health" 12SP17, Tunisia
| | - Mustafa al'Absi
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN
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19
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Elkholy H, Nagy N, Taha GRA, Elhabiby M, Yosef M, Azzam L. Stop Turning a Blind Eye: Tobacco Smoking Among Egyptian Patients With Schizophrenia. Front Psychiatry 2018; 9:703. [PMID: 30687137 PMCID: PMC6338023 DOI: 10.3389/fpsyt.2018.00703] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 12/03/2018] [Indexed: 11/17/2022] Open
Abstract
Background: Patients with schizophrenia have considerably higher rates of mortality than general population. Multiple factors may play a role in this. Despite being a major preventable cause of death, smoking is usually overlooked when dealing with patients with schizophrenia. Understanding the pattern of smoking, its severity, and the reasons to quit might be helpful in managing patients with schizophrenia and decreasing the mortality gap. Subjects and Methods: The study included smokers divided into two groups; the first included 346 patients with schizophrenia while the second group had 150 smokers with no mental illness. Both groups were assessed and compared regarding sociodemographic variables, pattern of smoking, severity of nicotine dependence, and motivation to quit smoking. Results: Earlier age of starting to smoke, higher number of cigarettes per day, and lower dependency scores were noted in patients with Schizophrenia. Positive correlation was found between positive symptoms and severity of dependence. Specific positive symptoms were correlated to number of cigarettes per day and time before first cigarette. Patients with Schizophrenia showed a significant difference in intrinsic reasons to quit (health concerns and self-control), which were also positively correlated to their positive symptoms score. Linear regression analysis for predictors of FTND score revealed that only age, sex, and schizophrenia were significant predictors of FTND score. Conclusion: Patients with schizophrenia smoke at earlier ages and smoke more cigarettes per day, yet, have less severe dependence than non-schizophrenic counterparts. Positive symptoms play a role in their smoking pattern and severity. Health concerns and self-control are their main motives to quit smoking.
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Affiliation(s)
- Hussien Elkholy
- Neurology and Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nahla Nagy
- Neurology and Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ghada R A Taha
- Neurology and Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mahmoud Elhabiby
- Neurology and Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mostafa Yosef
- Community Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Lobna Azzam
- Neurology and Psychiatry Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Bou Khalil R, Chaar A, Bou-Orm I, Aoun-Bacha Z, Richa S. The Relationship between Emotional Intelligence and Nicotine Dependence in Lebanese Adults. J Psychoactive Drugs 2017; 49:252-257. [PMID: 28266897 DOI: 10.1080/02791072.2017.1292435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Emotional intelligence (EI) is known to be a risk factor for several types of addiction. The purpose of this study was to investigate, in a cross-sectional design, the presence of a relationship between the level of EI and nicotine dependence in a sample of Lebanese adults. A self-administered questionnaire was used to determine the sociodemographic characteristics, the level of nicotine dependence, and the level of EI in a sample of 142 Lebanese participants from the community. The sample was 51.4% women, with a mean age of 33.9 years. There was no difference in EI level between smokers and non-smokers (p = 0.66), and there were no associations between EI level and the level of nicotine dependence (p = 0.59). However, EI was positively correlated with age (p = 0.023). Due to the fact that smokers have been dependent on nicotine for many years and that EI is known to increase with age, findings suggest that low EI may be a risk factor for initiation, rather than maintenance, of nicotine dependence.
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Affiliation(s)
- R Bou Khalil
- a Attending and Lecturer , Hotel Dieu de France Hospital and Saint Joseph University , Beirut , Lebanon
| | - A Chaar
- b Resident, Department of Internal Medicine , Hotel Dieu de France Hospital and Saint Joseph University , Beirut , Lebanon
| | - I Bou-Orm
- c Coordinator, Non Communicable Diseases (NCD) Department , Ministry of Public Health , Beirut , Lebanon
| | - Z Aoun-Bacha
- d Attending and Assistant Professor, Department of Pulmonology and Tobaccology , Hotel Dieu de France Hospital and Saint Joseph University , Beirut , Lebanon
| | - S Richa
- e Associate Professor, Head of Department of Psychiatry , Hotel Dieu de France Hospital and Saint Joseph University , Beirut , Lebanon
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Riaz M, Lewis S, Coleman T, Aveyard P, West R, Naughton F, Ussher M. Which measures of cigarette dependence are predictors of smoking cessation during pregnancy? Analysis of data from a randomized controlled trial. Addiction 2016; 111:1656-65. [PMID: 26997495 PMCID: PMC5084769 DOI: 10.1111/add.13395] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 11/26/2015] [Accepted: 03/14/2016] [Indexed: 11/27/2022]
Abstract
AIMS To examine the ability of different common measures of cigarette dependence to predict smoking cessation during pregnancy. DESIGN Secondary analysis of data from a parallel-group randomized controlled trial of physical activity for smoking cessation. The outcomes were biochemically validated smoking abstinence at 4 weeks post-quit and end-of-pregnancy. SETTING Women identified as smokers in antenatal clinics in 13 hospital trusts predominantly in southern England, who were recruited to a smoking cessation trial. PARTICIPANTS Of 789 pregnant smokers recruited, 784 were included in the analysis. MEASUREMENTS Using random-effect logistic regression models, we analysed the effects of baseline measures of cigarette dependence, including numbers of cigarettes smoked daily, Fagerström Test of Cigarette Dependence (FTCD) score, the two FTCD subscales of Heaviness of Smoking Index (HSI) and non-Heaviness of Smoking Index (non-HSI), expired carbon monoxide (CO) level and urges to smoke (strength and frequency) on smoking cessation. Associations were adjusted for significant socio-demographic/health behaviour predictors and trial variables, and area under the receiver operating characteristic (ROC) curve was used to determine the predictive ability of the model for each measure of dependence. FINDINGS All the dependence variables predicted abstinence at 4 weeks and end-of-pregnancy. At 4 weeks, the adjusted odds ratio (OR) (95% confidence interval) for a unit standard deviation increase in FTCD was 0.59 (0.47-0.74), expired CO = 0.54 (0.41-0.71), number of cigarettes smoked per day 0.65 (0.51-0.84) and frequency of urges to smoke 0.79 (0.63-0.98); at end-of-pregnancy they were: 0.60 (0.45-0.81), 0.55 (0.37-0.80), 0.70 (0.49-0.98) and 0.69 (0.51-0.94), respectively. HSI and non-HSI exhibited similar results to the full FTCD. CONCLUSIONS Four common measures of dependence, including number of cigarettes smoked per day, scores for Fagerström Test of Cigarette Dependence and frequency of urges and level of expired CO, all predicted smoking abstinence in the short term during pregnancy and at end-of-pregnancy with very similar predictive validity.
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Affiliation(s)
- Muhammad Riaz
- Population Health Research Institute, St George's University of LondonLondonUK
| | - Sarah Lewis
- Division of Epidemiology and Public Health and UK Centre for Tobacco and Alcohol StudiesUniversity of NottinghamNottinghamUK
| | - Tim Coleman
- Division of Primary Care and UK Centre for Tobacco and Alcohol StudiesUniversity of NottinghamNottinghamUK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK
| | - Robert West
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCLLondonUK
| | - Felix Naughton
- Behavioural Science Group, Institute of Public HealthUniversity of CambridgeCambridgeUK
| | - Michael Ussher
- Population Health Research Institute, St George's University of LondonLondonUK
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Shalaby AS, Sweilum OAEH, Ads MK. Does Tramadol Increase the Severity of Nicotine Dependence? A Study in an Egyptian Sample. J Psychoactive Drugs 2015; 47:197-202. [DOI: 10.1080/02791072.2015.1050534] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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23
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Pavarin RM, Biolcati R. Women between normality and dependence: a study of problematic consumption and dependence in women aged 30–50 years. JOURNAL OF SUBSTANCE USE 2015. [DOI: 10.3109/14659891.2013.878759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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24
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An investigation of cigarettes smoking behavior and nicotine dependence among Chinese methamphetamine users in two provinces. BIOMED RESEARCH INTERNATIONAL 2014; 2014:175205. [PMID: 25025035 PMCID: PMC4082854 DOI: 10.1155/2014/175205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 05/19/2014] [Accepted: 05/19/2014] [Indexed: 11/17/2022]
Abstract
Objective. To survey cigarette behaviors and nicotine dependence among Chinese MA users, explore risk factors for high nicotine dependence, and analyze the relationship between nicotine dependence and MA-related euphoria and sexual impulse. Methods. A cross-sectional study, applying a self-designed questionnaire with the Fagerström Test for Nicotine Dependence (FTND) and Visual Analog Scale (VAS), was performed among 391 MA users in Beijing and Guangdong, China. Results. Most MA users were smokers, including 159 having high dependence on nicotine (HD users, FTND > 5) and 197 low or medium dependent (LMD users, FTND ≤ 5). Men or married users were more likely to be highly dependent than women or unmarried users. Higher MA dose and ever-use of ketamine or alcohol were associated with higher likelihood of high nicotine dependence. HD users reported significantly higher euphoria and stronger sexual impulse after using MA, indicated by higher VAS scores. Conclusions. Potential risk factors for high nicotine dependence among MA users may include male gender, being married, higher MA dosage, and ever-use of ketamine or alcohol, which should be taken into consideration in individualized health promotion on smoking cessation. Severe nicotine dependence was associated with stronger MA-related euphoria and sexual impulse and it should be confirmed by further studies.
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